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真菌性食管炎的临床特征与表现:中国南方单中心经验

Clinical Characteristics and Manifestations of Fungal Esophagitis: A Single-Center Experience in South China.

作者信息

Zhan Shu-Kai, Wu Xiao-Qin, Zheng Feng-Ping

机构信息

Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.

出版信息

Gastroenterol Res Pract. 2021 Jan 18;2021:8869494. doi: 10.1155/2021/8869494. eCollection 2021.

Abstract

Fungal esophagitis is a common infectious disease, although the pathogenic clinical characteristics remain incompletely clear, especially in South China. The goal of this study was to investigate the pathogenic clinical characteristics of fungal esophagitis and the efficacy of different therapeutic strategies at a tertiary hospital in South China. A retrospective study was conducted from January 2007 to December 2017. Data from 113,390 patients who were treated in the endoscopic unit were retrieved and analyzed. To further understand the pathogen and risk factors for fungal esophagitis, we performed a case-control analysis of 101 patients and 202 controls. Of the 113,390 patients, 932 (0.82%) were positive. The annual detection rate ranged from 0.345% to 1.106%, showing an initially increasing and subsequently decreasing trend. The patients' median age was 49 years (range from 8 to 85), and most were men (615/932, 65.99%). was found in samples collected from 36 patients, without any drug-resistant strains. Age ( = 0.018), malignancy (OR = 4.031, 95% CI: 1.56210.407), cigarette smoking (OR = 3.017, 95% CI: 1.6455.533), and the use of antibiotics (OR = 2.178, 95% CI: 1.0784.400) or immunosuppressants (OR = 6.525, 95% CI: 1.08939.105) were independently associated with esophageal candidiasis. Fluconazole had a better curative effect than nystatin (OR = 4.047, 95% CI: 1.28212.772) or simple observation (OR = 8.91, 95% CI: 2.6130.49). In conclusion, fungal esophagitis primarily affects men and elderly individuals; it develops in the setting of malignancy, smoking, and certain previous medication use. is the most common pathogen and is sensitive to antifungal agents. Fluconazole has a good therapeutic effect.

摘要

真菌性食管炎是一种常见的感染性疾病,尽管其致病的临床特征仍不完全清楚,尤其是在华南地区。本研究的目的是调查华南地区一家三级医院真菌性食管炎的致病临床特征以及不同治疗策略的疗效。我们进行了一项回顾性研究,时间跨度为2007年1月至2017年12月。收集并分析了在内镜科接受治疗的113390例患者的数据。为了进一步了解真菌性食管炎的病原体和危险因素,我们对101例患者和202例对照进行了病例对照分析。在113390例患者中,932例(0.82%)检测呈阳性。年检测率在0.345%至1.106%之间,呈先上升后下降的趋势。患者的中位年龄为49岁(范围为8至85岁),大多数为男性(615/932,65.99%)。在36例患者的样本中发现了[具体真菌名称未给出],未发现任何耐药菌株。年龄(P = 0.018)、恶性肿瘤(OR = 4.031,95%CI:1.56210.407)、吸烟(OR = 3.017,95%CI:1.6455.533)以及使用抗生素(OR = 2.178,95%CI:1.0784.400)或免疫抑制剂(OR = 6.525,95%CI:1.08939.105)与食管念珠菌病独立相关。氟康唑的疗效优于制霉菌素(OR = 4.047,95%CI:1.282~12.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78e9/7834832/9f1f70e6f6a7/GRP2021-8869494.001.jpg

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